Background
The funnel chest directly presses the right ventricle due to the posterior recessed chest wall, which results in a decrease in right heart function. There are some limitations and inaccuracies in the evaluation of right heart function in children with funnel chest using conventional echocardiographic section and parameters. The aim of this study was to evaluate the changes of right ventricular function in preoperative and postoperative periods in children with funnel chest by modified xiphoid tricuspid annulus displacement (SEATAK), and to provide evidence for selection of surgical timing and prognosis.
Method(s)
A total of 40 children with closed funnel-thoracic surgery were selected, who had been admitted to our hospital from 2015 to 2018. Forty healthy children were selected as control group. The triceps tricuspid annulus displacement was measured using the Philips iE33 echocardiographic imaging platform, and the parameters such as tricuspid annular plane systolic excursion (TAPSE) and right ventricular area change fraction RVFAC% were measured and then compared between the two groups.
Result(s)
(1) Compared with the control group, SEATAK was significantly decreased in children with funnel chest (P<0.05).
(2) The decreasing degree of SEATAK in children with funnel chest was significantly positively correlated with TAPSE (r=0.892, P<0.001), and reduction in SEATAK was positively correlated with FAC (r=0.715, P<0.001).
(3) The decreasing degree of postoperative SEATAK was positively correlated with TAPSE (r=0.73, P<0.001), SEATAK increased, and FAC significantly increased (P<0.05).
Conclusion(s)
Modified semi-quantitative evaluation of right ventricular function by tricuspid annulus displacement under xiphoid can avoid inaccurate measurement caused by factors such as sternal sag and postoperative plate occlusion. It has the advantages of clearness, simplicity, easy operation and good reproducibility. Combined with TAPSE and FAC, it can significantly improve the accuracy of evaluating the right ventricular function in children with funnel chest by echocardiography, and it is of great application value in guiding clinical treatment and prognosis evaluation.

Semi-quantitative evaluation of right ventricular function in children with funnel chest by modified xiphoid tricuspid annulus displacement

ECHO ASIA is organized by Asian-Pacific Association of Echocardiography (AAE). The meeting combines the basic echocardiography training curriculum and the state-of-the-art lectures/scientific sessions provided by international as well as Asian-Pacific experts. The meeting is a unique forum where scientists from many countries in the Asian-Pacific region who are involved in the field of Doppler echocardiography gather together to exchange knowledge and skills. Various internationally distinguished faculties consent to present their findings and reveal their clinical experiences in ECHO ASIA.